Breast holder for mammograph

ABSTRACT

An apparatus for holding a female breast immobilized extended away from the chest cavity and flattened to allow examination by passing radiation through the breast. Two flexible sheets transparent to radiation are drawn together on the breast under examination by an apparatus which provides for controlling the angle between the two sheets.

United mares Patent QR 3955690551 v.

[72] Inventor Henry S. Jones New Canaan, Conn.

[21] Appl, No. 730,344

[22] Filed May 20, 1968 [45] Patented Jan. 19, 1971 [73] AssigneeHolotron Corporation Wilmington, Del. a corporation of Delaware [54]BREAST HOLDER FOR MAMMOGRAPH 6Claims,3Drawing Figs. g 521 U.S.Cl.1...1.i.,:.l.,, 128/2, 73/67.5: 128/241250/50 51 lnt.Cl A6lb6/04 [50]FieldofSearch 128/2,

[56] References Cited UNITED STATES PATENTS 3,237,623 3/1966 Gordon128/24 3,480,002 1 H1969 Flaherty et a1 128/2 2,111,903 3/1938 Rona250/50 2,532,507 12/1950 Meunier 128/24.05UX

2,826,702 3/1958 Campbell et a1 250/5OX 3,165,630 1/1965 Bielatetal250/50X 3,293,430 12/1966 Wustner 250/50X 3,302,021 1/1967 Hardy .1250/50 7 FOREIGN PATENTS 1,164,093 5/1958 France 250/50 OTHER REFERENCESELECTRONlCS, Mar, 1955, p.174. (copy in GR. 335 128/2405) JOURNAL OF THEACOUSTICAL SOCIETY OF AMER, Vol. 23, No. 2, Mar. 1951, pp. 160 167,(copy in GR 335,128/2405) Primary Examiner-Richard A. Gaudet AssistantExaminerKyle L. Howell Attorney-Woodcock, Washburn, Kurtz & MacKiewiczABSTRACT: An apparatus for holding a female breast immobilized extendedaway from the chest cavity and flattened to allow examination by passingradiation through the breast. Two flexible sheets transparent toradiation are drawn together on the breast under examination by anapparatus which provides for controlling the angle between the twosheets.

PATENTED JAN] 9 I97! SFEU 1 OF 2 PATENIED JAN 1 9 12m SHEET 2 BF 2BREAST HOLDER FOR MAMMOGRAPH BACKGROUND OF THE INV ENTION This inventionis related to female breast examination and more specifically toapparatus for holding a breast during radiation examination thereof.

During radiation examination of a breast for an internal abnormal growthsuch as cancerous tissue, some means is required for holding the breastimmobilized while radiation is applied. Mammograph equipment whichutilizes compressional wave energy in the ultrasonic range as theradiation passes through the breast under examination is fully describedin the copending application by Byron B. Brenden entitled ImprovedUltrasonic Imaging Technique and Mammograph Equipment," Ser. No. 736,260filed May 20, 1968, commonly assigned with the present application.

For best results, the breast should be immobilized so that it is notmoved during such a radiation examination. Furthermore, the breastshould be held away from the woman's chest cavity, a requirementespecially important in ultrasonic mammograph equipment. Also, thebreast should be flattened somewhat.

It is desirable that the breast be so held without severe discomfort tothe woman patient. Also, the breast holder should not substantiallyattenuate the radiation passing through the breast or otherwiseinterfere with the examination. Furthermore. a breast holder must beeffective for a large variety of breast sizes.

SUMMARY OF THE INVENTION These desirable characteristics and objects ofthis invention are accomplished by an apparatus which includes twoflexible sheets transparent to the examining radiation with means todraw the sheets together from either side of a breast under examinationand further having means to control the angle between the sheets as theyare so drawn together so that the breast may be first compressed nearthe chest cavity and then placed under substantially even compression.

Although the scope of this invention is defined in the appended claims,the following detailed description taken in light of the accompanyingdrawings is intended to aid an understanding of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 illustrates ultrasonicmammograph equipment in which the apparatus of the present invention maybe utilized;

FIG. 2 illustrates a patient supporting surface for the ultrasonicmammograph equipment of FIG. I which may be used in conjunction with thebreast holding apparatus of this invention; and

FIG. 3 shows a preferred embodiment of the breast holding apparatus ofthis invention.

DESCRIPTION OF THE PREFERRED EMBODIMENT There are several techniques forimaging the internal structure of a breast for medical diagnosis ofabnormal growths therein, such as cancerous tissues. Passing X-raysthrough the breast give information of the density variations within thebreast. Pulse-echo ultrasonic techniques will detect substantialvariations in internal structure. The ultrasonic method of Byron B.Brenden as disclosed in the aforementioned copending application teachespassing a beam of ultrasonic energy through the breast to image densityand molecular binding variations therein with greater detail thanbefore. This method is disclosed with reference to FIG. 1 as one exampleof a use for the breast holder of this invention.

Since ultrasound is heavily attenuated in a gas such as air and isfurther heavily reflected when passing from air to a solid object, afemale breast is best imaged by submersing it in an ultrasonictransmitting liquid medium of high efliciency. This medium should becompatible with the female breast so that no more than a smallproportion of energy will be reflected as the ultrasound passes from theliquid medium to the breast and through to the liquid medium again. Ithas been found that water is quite satisfactory and, of course.available in large quantities and is further comfortable for thepatient. To avoid having to submerse more of the patient in the waterthan the breast under examination. it has been found preferable toposition the woman in a horizontal position and extend the breast underexamination down through a top surface of the water and pass theultrasonic energy beam substantially parallel to and immediately belowthe water surface through the breast.

FIG. 1 illustrates this preferred technique. A tank 200 contains anultrasonic transmitting water 202 and a woman 204 is held in a proneposition over the tank by a supporting surface 206. A breast 207 underexamination is suspended into the water 202 through an opening in thesupporting surface 206. A quartz transducer 208 held in place by ahousing 210 is a preferred source ofa substantially plane waveultrasonic beam 212 which is propagated through the water 202 to thebreast 207. The ultrasonic wavefront passing through the breast isimaged by an ultrasonic lens 213 onto an ultrasonic detector such as thearea detector 214 which is shown to be of a type such as a Pohlman cell.A light source 216 illuminates the observers side of the area detector214, thereby displaying in the optical domain a representation of theultrasonic wavefront which has passed out of the breast 207.

A primary consideration in the configuration shown in FIG. 1 is to allowroom for the transducer housing 210 above a surface 218 of water filledcontainer 200 which then permits the ultrasonic energy beam 212 to bepropagated very close to the surface 218 and thus image a large portionof the breast 207 without having to immerse any more of the woman in thewater. To allow as much of the breast 207 as possible to be placed intothe liquid 202, the supporting surface 206 has been sloped from bothdirections to the breast opening.

A preferred range of frequencies of the ultrasonic energy beam 212 hasbeen found to be between I and I0 Megahertz (MI-12.). Below I MHz.,resolution has been found to be inferior, and above 10 MI-Iz., has beenfound to be preferred for breast examination. The transducer 208 ispreferably an X-cut quartz crystal with a 1 MHz. fundamental frequencywhich is operated at 3 MHz. by a power supply at that frequency,according to well-known techniques. The power supply equipment could behoused within the examination equipment next to the tank 200 in an area230 of FIG. 1.

The technique of ultrasonic imaging as described with respect to FIG. 1provides for real time examination of a breast. This has the advantagethat the breast may be properly positioned and flattened and other partsof the apparatus adjusted, such as the ultrasonic lens 213, in order togive a good image that is of value for medical diagnostic work.

A preferred female patient support surface and the breast holder of thisinvention are shown in FIGS. 2 and 3. A patient support surface 300 ofFIG. 2 has a depressed surface area 302 for allowing the patients chestcavity of her body to be placed close to the liquid medium below and herbreast placed in the liquid through an opening 306. A further depression304 in the depressed surface 302 is designed for the patients rightshoulder so that she may lie slightly on her right side and therebycause her rib cage to contact the edges of the opening 306 for most ofthe breasts perimeter. This firm contact is necessary to prevent thebreast from slipping up and out of the holder below. In a similarmanner, another surface depression 308 is provided for the femalepatients left shoulder to facilitate placing her left breast as farthrough the opening 306 as is possible without slipping out of theholder.

Surrounding the opening 306 on the underneath of the support surface 300is a preferred embodiment of the breast holder of this invention whichcan' be seen in detail by reference to FIG. 3. A boxlike frame 310 hasas one end thereof a U-shaped support plate 312 which holds a thinmembrane 314 in tension. The membrane 314 is preferably a polymeric filmsuch as polyester, polyethylene or polypropylene, and should besubstantially transparent to the ultrasonic wavelength used. A secondU-shaped support plate 316 holds a similar membrane 318 in a stressedcondition. The support plate 316 is placed within the frame 310 to forma breast cavity between the membranes 314 and 318. The support plate 316further has cylindrical guide members 320 and 322 attached to theopposite sides thereof. These cylindrical members are mounted withinguideslots 324 and 326 of opposite generally parallel sides of the frame310 in a manner so that the support plate 316 may be rotated about theaxial center line common to the cylindrical members 320 and 322 andfurther to be slideable along the two guide slots 324 and 326. The guideslots 324 and 326 are generally perpendicular to the support plate 312.

The support plate 316 is resiliently held away from the support plate312 by a spring 327 connected between the cylindrical member 320 and theunderside of the support surface 300, and a second spring (not shown)between the cylindrical member 322 and the support surface 300. When abreast is positioned between the membranes 314 and 318, the supportplate 316 is drawn toward the support plate 312, thereby placing thebreast under compression. This movement is made by operating a controlknob 332 which is operably connected through a control gear box 335 withthe upper side of the U- shaped plate 316 by means of ropes 328 and 330.Similarly, motion front the turning of a control knob 334 iscommunicated to the bottom edge of the U-shaped plate 316 by ropes 331and 333 through the control gear box 335. Several pulleys are shown overwhich these four ropes move between the support plate 316 and the gearcontrol box 335.

To operate the breast holder, movement is applied to the ropes 328 and330 initially to pull the top edge of the membrane 318 against thebreast, thereby to hold the breast away from the chest cavity andwithout slipping out of the holder when the rest of the breast is placedunder compression. Motion is then applied to the ropes 331 and 333 topull the bottom portion of the membrane 318 against the breast to holdit at approximately uniform .thickness over the area through whichultrasound is projected.

The membranes 314 and 318 have beads 315 and 319, respectively, alongtheir open edges for contacting and conforming to the varied curves ofthe chest wall. These beaded edges are held taut to increase the initialpinch effect which prevents the breast from creeping up and out of theholder.

When the breast is so immobilized, ultrasonic energy is passed throughthe breast and its two surrounding membranes 314 and 318 without passingthrough the rib cage and is then imaged onto an area detector ashereinabove described. When the examination is complete, the supportplate 316 is released from compression. This may be accomplished by somemechanism within the control gear box 335 to release tension on theropes.

It shall be understood that the invention described herein is notlimited to the specific arrangements shown and that changes andmodifications may be made within the scope of the appended claims.

lclaim:

1. Apparatus for holding a breast of a female in a flattened positionaway from her body, comprising:

a frame including at least two opposite generally parallel sidessupported in a fixed spatial relationship with each other;

a first U-shaped plate held between the sides of said frame andgenerally perpendicular thereto, said first plate oriented to openupward and having a flexible membrane held in tension thereby, saidmembrane being substantially transparent to compressional wave radiationin at least the ultrasonic range;

a guide slot in each of said opposing frame members generallyperpendicular to said first plate, said slots being substantiallyparallel with each other;

a second U-shaped plate having outwardly extending guide members on oposite sides thereof, said uide members mounted in san guide slots tohold sat second plate rotatably and slidably between said frame sides,said second plate oriented to open upward and having a flexi blemembrane held in tension thereby, said membrane being substantiallytransparent to compressional wave radiation in at least the ultrasonicrange; and

means for drawing said second U-shaped plate relative to said framesides toward said first U-shaped plate in a manner that said secondU-shaped plate may be rotated about an axis joining its guide memberswhile being moved toward the first U-shaped plate.

2. Apparatus according to claim 1 wherein said flexible membranes aremade ofa polymeric film material.

3. Apparatus according to claim 1 wherein said means for drawing saidsecond plate toward the first plate includes a first means operablyconnected to the second plate on one side of the axis joining its guidemembers and a second means independent of said first means operablyconnected to the second plate on an opposite side of the axisjoining itsguide members.

4. A female patient supporting table for compressional wave' energydiagnostic examination of a female breast, comprising:

an open top tank adapted to contain a compressional wave energytransmitting liquid;

a rigid generally horizontal patient supporting member positioned oversaid tank and having a patient supporting surface on an upper side withan underneath side acting as a cover to said tank;

an opening through said supporting member adapted to accommodate abreast of a female patient lying on said table surface, said openingbeing surrounded by an area of said supporting surface that slopesgently toward the opening thereby to depress said opening somewhat intosaid tank;

a pair of surface depressions in the sloping area of the supportingsurface on either side of said opening, each depression shaped toaccommodate a shoulder of the patient, whereby a female patient lyingpartially on her side may engage one of said shoulder depressions tocompletely insert a breast into said tank through said opening;

a pair of flexible membranes in tension held by the underneath side ofsaid patient supporting membrane and positioned within said tank onopposite sides of said opening, said membranes being substantiallytransparent to compressional wave radiation in at least the ultrasonicrange and shaped to accommodate the female breast in compressiontherebetween; and

means for drawing at least one of said membranes relative to the patientsupporting member toward the other membrane, including means for tiltingat least one of said sheets relative to the patient supporting member asthey are drawn together.

5. The female patient supporting table according to claim 4 wherein eachof said flexible membranes is held stretched across a rigid U-shapedframe opening upward.

6. The female patient supporting table according to claim 5 wherein saidflexible membranes are made of a polymeric film material.

mg? UNITED STA'IES PAT ENT OFFICE CER'IIFICA'LE OF CORRECTIOIJ PatentNo. 3 6 w" ,lanuary. l34 l9ll Invcntor(s) Henry S Jones It is certifiedthat error appears in the above-identified patent and that said LettersPatent are hereby corrected as shown below:

Column 2, line 40, after 10 MHz, a line was omitted which 18 thefollowing:

a breast is not transparent to the u ltrasonic energy.

An operating frequency of 3 MHz.--

Claim 4 line 49, change the word "membrane" to --member-.

Signed and sealed this 1 8th day of May 1 971 SEAL) Atte st:

EDWARD M.FLETGHER,JR. WILLIAM E. SCHUYLER, JR. Atte st ing Officer"Commissioner of Patents

1. Apparatus for holding a breast of a female in a flattened positionaway from her body, comprising: a frame including at least two oppositegenerally parallel sides supported in a fixed spatial relationship witheach other; a first U-shaped plate held between the sides of said frameand generally perpendicular thereto, said first plate oriented to openupward and having a flexible membrane held in tension thereby, saidmembrane being substantially transparent to compressional wave radiationin at least the ultrasonic range; a guide slot in each of said opposingframe members generally perpendicular to said first plate, said slotsbeing substantially parallel with each other; a second U-shaped platehaving outwardly extending guide members on opposite sides thereof, saidguide members mounted in said guide slots to hold said second platerotatably and slidably between said frame sides, said second plateoriented to open upward and having a flexible membrane held in tensionthereby, said membrane being substantially transparent to compressionalwave radiation in at least the ultrasonic range; and means for drawingsaid second U-shaped plate relative to said frame sides toward saidfirst U-shaped plate in a manner that said second U-shaped plate may berotated about an axis joining its guide members while being moved towardthe first U-shaped plate.
 2. Apparatus according to claim 1 wherein saidflexible membranes are made of a polymeric film material.
 3. Apparatusaccording to claim 1 wherein said means for drawing said second platetoward the first plate includes a first means operably connected to thesecond plate on one side of the axis joining its guide members and asecond means independent of said first means operably connected to thesecond plate on an opposite side of the axis joining its guide members.4. A female patient supporting table for compressional wave energydiagnostic examination of a female breast, comprising: an open top tankadapted to contain a compressional wave energy transmitting liquid; arigid generally horizontal patient supporting member positioned oversaid tank and having a patient supporting surface on an upper side withan underneath side acting as a cover to said tank; an opening throughsaid supporting member adapted to accommodate a breast of a femalepatient lying on said table surface, said opening being surrounded by anarea of said supporting surface that slopes gently toward the openingthereby to depress said opening somewhat into said tank; a pair ofsurface depressions in the sloping area of the supporting surface oneither side of said opening, each depression shaped to accommodate ashoulder of the patient, whereby a female patient lying partially on herside may engage one of said shoulder depressions to completely insert abreast into said tank through said opening; a pair of flexible membranesin tension held by the underneath side of said patient supportingmembrane and positioned within said tank on opposite sides of saidopening, said membranes being substantially transparent to compressionalwave radiation in at least the ultrasonic range and shaped toaccommodate the female breast in compression therebetween; and means fordrawing at least one of said membranes relative to the patientsupporting member toward the other membrane, including means for Tiltingat least one of said sheets relative to the patient supporting member asthey are drawn together.
 5. The female patient supporting tableaccording to claim 4 wherein each of said flexible membranes is heldstretched across a rigid U-shaped frame opening upward.
 6. The femalepatient supporting table according to claim 5 wherein said flexiblemembranes are made of a polymeric film material.